'Warn all patients of dangers of statins' says experts

LEADING heart specialists are warning doctors not to “mislead” patients over “exaggerated” benefits of controversial cholesterol busting pills, statins, and to caution them about their potentially “disabling” side effects.

The missive, by Professor Simon Capewell, Vice President of the Faculty of Public Health, and two leading heart doctors urges medics to be “transparent” about the risks and benefits of statins to patients and refrain from “scaremongering” over the “risks” of stopping the drugs if patients suffer “disabling” side effects. 

The warning, published in the latest edition of the UK’s leading drug advisory journal for  GP’s and hospital doctors, The Prescriber, comes after advice from the government drug watchdog NICE advocated the use of statins in low risk patients which would include at least one in four adults. 

Such widespread use of the drugs is challenged by the authors of the report who say statins have no effect on life expectancy for patients at low risk and instead expose healthy people to potential side effects that impair quality of life. 

Using published data the report concludes the benefit of taking a statin for this group is  only to reduce the risk of a non fatal heart attack or stroke by less than one per cent over five years. They argue this benefit is offset by a similar risk of developing a life altering side effect  of type two diabetes.

The authors highlight the drug company Pfizer’s own patient leaflet on statin side effects which admits the drug adversely affects up to one in ten patients and include muscle and joint pain, nausea, digestive problems, sore throat and increases in blood sugar levels.

Drawing on published data the article concludes even in patients with established heart disease the risk of death in stopping the drug for one day is a only 1 in 150,000.  

Klim McPhearson, 73, a Professor of public health at Oxford University stopped taking statins  after he developed side effects. 

The father of three, who was prescribed statins two years ago because of a raised cholesterol told the Sunday Express: “The side effects happened gradually over two years. I became stiffer and got pains in my legs. I thought  it was due to ageing. Eventually it got to the point that I could hardly walk downstairs because of the pain. When I stopped taking statins it got better.” 

He said: “My risk of heart disease was low, the benefit of statins was very small but the  side effects were overwhelming. People should be aware that side effects may outweight the benefits.” 

Dr Andrew Apps, a Buckinghamshire based heart specialist and co-author of the report said:  “Doctors generally have less time to treat patients and discuss their condition. It is faster to instead prescribe a medicine which may not have benefit.

"Patients are not being properly informed of the risks and benefits of these drugs and as a result doctors  are medicalising a whole subset of society who is well and may not need drugs.” 

Dr Aseem Malhotra a London based leading heart specialist and another of the report’s authors said: “Doctors have an ethical duty to give full information about the benefits and risks of this treatment which I do not believe is always happening.” 

Last year a Sunday Express investigation revealed eight out of 12 members of the Nice panel which drew up the new statin guidance are in the pay of the drug companies that manufacture them or next generation cholesterol lowering drugs. 

These include payments for speeches, lectures or to attend conferences which can reap thousands of pounds per hour. 

They also include salaries for involvement in clinical trials of new statin-style drugs,  which can amount to tens of thousands of pounds a year, payment for drug company advisory roles, and in one case a sponsorship of a work post. 

Last year leading doctors magazine PULSE revealed two-thirds of GPs are disregarding NICE  advice to offer statins to more patients.

In its survey of more than 560 GP’s two thirds said they had not started prescribing the  drugs to the lower risk groups. The chair of the General Practitioners prescribing committee said there should be: ‘no..  slavish devotion’ to guidelines, while GPs indicated they have ongoing doubts there is enough evidence the benefits of statins outweigh the harms in lower-risk people, and concerns around “medicalisation” of healthy people. 

Professor Mark Baker, Director of the Centre for Clinical Practice at NICE said: “To make  progress in the battle against heart disease and stroke, we must encourage exercise, improve our diets still further, stop smoking, and where appropriate offer statins to people at risk.

"Doctors have been giving statins to “well people” since NICE first produced guidance on this in 2006. The overwhelming body of evidence supports their use, even in  people at low risk of cardiovascular disease. The effectiveness of these medicines is now well proven, as is their safety, and their cost has fallen.”

http://www.express.co.uk/

Graham